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OUTLINES 


OF 

THE  NERVES: 

WITH  SHORT  DESCRIPTIONS. 


DESIGNED  FOE  THE  USE  OF  MEDICAL  STUDENTS. 


BY  JOHN  NEILL,  M.D., 

Demonstrator  of  Anatomy  in  the  University  of  Pennsylvania,  Physician  to  Wills's  Hospital, 
Lecturer  on  Anatomy,  etc  , etc.,  etc. 


PHILADELPHIA: 

ED.  BARRINGTON  AND  GEO.  D.  HASWELL. 

1 8 4 5. 


I 


Entered,  according  to  act  of  Congress,  in  the  year  1845,  by  Bariiixotox  and 
Haswell,  in  the  Clerk’s  office  of  the  District  Court  for  the  Eastern  District  of 
Pennsylvania. 


WILLIAM  GIBSON,  M.D 


PROFESSOR  OF  SURGERY  IN  THE  UNIVERSITY  OF  PENNSYLVANIA, 


THESE  PAGES 


ARE  RESPECTFULLY  INSCRIBED. 


Abdomino-Crural 

- 

- 

26 

Gangliform  Plexus 

- 

- 

18 

Accessorius 

- 

- 

10 

Glosso-Pharyngeal 

“ 

10 

17 

Anterior  Crural  - 

- 

- 

27 

Gluteal 

- 

- 

28 

Anterior  Cutaneous 

- 

- 

27 

Great  Splanchnic 

- 

- 

21 

Anterior  Dental  - 

- 

- 

13 

Gustatory  - 

- 

- 

15 

Anterior  Tibial  - 

- 

- 

29 

Auditorius  - 

- 

10 

17 

Hypogastric  Plexus 

- 

- 

22 

Axillary 

- 

- 

24 

Hypoglossal 

- 

10 

19 

Axillary  plexus  - 

- 

- 

24 

Inferior  Cardiac  - 

- 

21 

Brachial  Plexus  - 

- 

- 

24 

Inferior  Dental 

- 

15 

Buccal 

- 

- 

16 

Inferior  Laryngeal 

- 

IS 

Inferior  Long  Pudendal 

- 

28 

Cardiac  Plexus  - 

- 

- 

21 

Inferior  Maxillary 

- 

12 

Casserian  Ganglion 

- 

- 

12 

Infra-Orbital 

- 

13 

Cervico-Facial 

- 

- 

16 

Intercosto-Humeral 

- 

26 

Cervical  Nerves  - 

- 

23- 

-24 

Internal  Cutaneous  (arm) 

- 

25 

Cervical  Plexus  - 

- 

- 

16 

Internal  Cutaneous  (leg) 

- 

27 

Chorda  Tympani 

- 

- 

14 

Internal  Nasal 

- 

12 

Ciliary  branch 

- 

- 

11 

Internal  Peroneo-Cutaneous 

- 

29 

Ciliary  Nerves 

- 

- 

11 

Internal  Plantar  - 

- 

30 

Circumflex  - 

- 

- 

24 

Ischiatic  ... 

- 

28 

Cloquet’s  Ganglion 

- 

- 

14 

Communicans  Tibi® 

- 

- 

29 

Jacobson’s  Anastomosis 

- 

20 

Coronary  - 

- 

- 

21 

Cranial  Nerves  — course  and 

dis- 

Lachrymal  - 

- 

12 

tiibution  - 

- 

- 

10 

Laumonier's  Ganglion  - 

- 

15 

Cranial  Nerves  — origin 

- 

9 

Lenticular  Ganglion 

- 

1 1 

Cutaneous  Medius 

“ 

- 

27 

Lumbar  - 

* 

26 

Deep  Petrous 

- 

_ 

14 

Meckel’s  Ganglion 

_ 

13 

Descenders  Noni 

- 

- 

20 

Median 

. 

25 

Dorsal 

- 

- 

26 

Mental 

. 

15 

Middle  Cardiac 

. 

21 

External  Cutaneous  (of  arm) 

- 

25 

Motor  Externus  - 

- 

10, 

15 

External  Cutaneous  (of  leg) 

- 

26 

Motor  Oculi 

- 

9, 

1 1 

External  Peroneal 

- 

- 

29 

Musculo-Cutaneous 

- 

_ 

25 

External  Peroneo-Cutaneous 

- 

29 

Musculo-Spiral  - 

, 

25 

External  Plantar  - 

- 

. 

30 

External  Saphenus 

- 

- 

29 

Nasal  - 

_ 

_ 

12 

External  Spermatic 

- 

- 

26 

Naso-palatine 

- 

- 

13 

Nervi  Molles 

_ 

_ 

20 

Facial 

. 

10, 

15 

Frontal 

- 

- 

12  1 

Obturator  - 

- 

_ 

27 

6 


PA 


Olfactory 

- 

- 

9, 

Ophthalmic 

- 

- 

- 

Ophthalmic  Ganglion 

- 

- 

- 

Opticus 

- 

9, 

Patheticus  - 

_ 

_ 

9, 

Peroneal 

- 

- 

. 

Pes  Anserina 

- 

- 

- 

Pharyngeal  Plexus 

- 

- 

- 

Phrenic  Nerve 

- 

- 

- 

Pneumogastric 

- 

- 

10, 

Popliteal 

- 

- 

- 

Post-Auricular 

- 

- 

- 

Posterior  Cutaneous 

- 

. 

- 

Posterior  Dental  - 

- 

- 

13, 

Posterior  'J'ibial  - 

- 

- 

- 

Portio  Dura 

- 

- 

10, 

Portio  Mollis 

- 

. 

10, 

Pterygoid  - 

- 

- 

Pterygo-Palatine  - 

- 

- 

- 

Pulmonary  Plexus 

- 

* 

■ 

Radial 

_ 

_ 

Rami  Cardiaci 

- 

. 

- 

Ramus  Ciliaris 

- 

_ 

. 

Recurrent  - 

_ 

- 

- 

Recurrent  Laryngeal 

- 

- 

- 

Renal  Plexus 

- 

* 

- 

Sacral 

_ 

_ 

Saphenus  - 

- 

- 

- 

Scapular 

- 

- 

- 

Sciatic 

- 

- 

- 

DEX. 


Sciatic  Plexus 

page 
. 27 

Semilunar  Ganglion 

- 

- 

22 

Small  Splanchnic 

- 

- 

22 

Solar  Plexus  - - • 

- 

- 

22 

Spheno-palatine  - 

- 

- 

13 

Spinal  Accessory 

- 

17,  19 

Spinal  Nerves 

- 

- 

23 

Splenic  Plexus 

- 

- 

22 

Subscapular 

- 

- 

24 

Submaxillary  Ganglion 

- 

- 

15 

Sub-Occipital 

- 

- 

23 

Superficial  Cardiac 

- 

- 

20 

Superficial  Petrous 

- 

- 

14 

Superficial  Temporal  - 

- 

- 

15 

Superior  Laryngeal 

- 

- 

18 

Superior  Long  Pudendal 

- 

- 

28 

Superior  Maxillary 

- 

- 

13 

Superior  Mesenteric  Plexus 

- 

- 

22 

Superior  Pharyngeal  - 

- 

- 

18 

Sympathetic 

“ 

20 

Temporo-Facial  - 

- 

- 

16 

Thoracic  - - - 

- 

- 

24 

Tracheal  - 

- 

- 

19 

Trigeminus 

* 

- 

10 

Ulnar  ... 

- 

* 

25 

Vagus 

. 

10,  17 

Vidian  ... 

- 

14 

Wrisberg’s  Nerves 

- 

- 

26 

IN 

RK  | 

10 

12 

1 1 

10 

12 

28 

16 

18 

23 

17 

29 

16 

28 

14 

29 

15 

17 

14 

13 

19 

25 

18 

11 

14 

15 

22 

26 

27 

24 

28 


PREFACE. 


To  obtain  a correct  general  idea  of  a subject  is  the  best  means 
for  subsequently  acquiring  a more  accurate  and  extensive 
knowledge.  Hence,  in  all  sciences,  Elementary  Treatises  are 
placed  in  the  hands  of  beginners,  before  the  fuller  and  more  com- 
prehensive works. 

It  is  hoped  that  these  Outlines  will  afford  to  Students  of  Medi- 
cine a simple  and  concise  view  of  the  Nerves,  so  that  the  most 
important  branches  may  be  learned  without  difficulty  : and,  in 
order  to  avoid  the  confusion  and  trouble  arising  from  references 
made  in  the  usual  way,  the  names  have  been  placed  on  the  several 
filaments. 

In  a work  of  this  size,  it  is  not  to  be  supposed  that  all  the 
minutiae  of  the  discoveries  of  the  nervous  system  are  to  be  found; 
much  less  that  there  should  be  the  shadow  of  any  thing  original. 
If  what  is  already  known  be  made  clear  to  students,  and  an 
easy  mode  of  acquiring  it  be  presented  to  them,  the  object 


8 


PREFACE. 


will  be  accomplished.  Most  of  the  Plates  are  altered  from  others, 
so  as  to  suit  the  terms  and  descriptions  of  the  standard  text-books 
of  the  day. 

I am  indebted  to  Dr.  Lowber  for  the  Delineations. 


JOHN  NEILL. 


Nov.  1st,  1845. 
295  Spruce  street. 


I erves 


Plate  / 


st 


Z* Fair.  Optic 

3 d Fair.  Motor  Oculi 
P ^ Fair  PeUketicus 

7 Fair  P<?rtio  Faro.  <&  \ 

Portia  Mollis  J 

8 Pair  Par  Pay  urn,  . . - 
tilosso  Pharyngeal  ■& 
Spinal  Mcoessory . . . 


. S *$■  Pair  Trig etnimis 
.6*^-  Pair  Motor  JSoct. 


S tJl  Pair  PFypto glossal. 


fi'P  lieL 


T.  S .Du  vai.  Xiih  Phzl ' 


THE  NERVES. 


\ 


There  are  Thirty-nine  pairs  of  Nerves  which  arise  from  the  Spinal 
Marrow  and  Brain  ; nine  of  these  pairs  arise  from  the  Brain 
and  are  called  Cranial , the  remaining  thirty  arise  from  the 
Spinal  Marrow  and  are  called  Spinal. 

CRANIAL  NERVES  AND  THEIR  ORIGIN. 

PLATE  I. 

These  are  designated  numerically  with  reference  to  the  order  in 
which  they  apparently  arise  from  the  base  of  the  Brain. 
They  also  receive  names  from  their  function  and  mode  of 
distribution. 

They  are  as  follow  : — 

1.  Olfactorius,  — The  Olfactory  rises  by  three  roots,  apparently 
from  the  fissure  of  Sylvius  : actually  from  the  anterior  lobe 
of  the  brain. 

1.  Opticus.  — The  Optic  nerve  arises  from  the  Thalamus  nervi 
optici  and  the  Tubercula-quadrigemina. 

S.  Motor  Oculi.  — The  Motor  nerve  of  the  eye  arises  from  the 
internal  face  of  the  Crus  Cerebri. 

4.  Patheticus.  — The  Pathetic  nerve  arises  from  the  Valve  of 
the  Brain. 

2 


10 


OUTLINES  OF 


5.  ir  igeininus. — I he  irifacial  nerve  emerges  from  the  side 
of  the  Pons  Varolii  near  the  Crus  Cerebelli. 


6-  Motor  Extern  us.  — The  External  Motor  nerve  arises  from 
the  Corpus  Pyramidale. 


Facialis  vel  Portio  Dura.  — The  Facial  nerve  arises 
from  the  junction  of  the  Corpus  Restiforme  and  Me- 
dulla Oblongata. 


Audi  tori  us  vel  Portio  Mollis.— The  Auditory  nerve 
arises  from  the  Calamus  Scriptorius  and  Corpus  Resti- 
forme. 


- Glosso-Plia  ryngeus.  — The  Glosso-Pharyngeal  nerve 
arises  in  the  fissure  between  the  Corpus  Olivare  and 
Corpus  Restiforme. 

Pncumogastricusvel  Vagus  .—The  Pneumogastric  nerve 
8,  j arises  from  the  same  fissure  as  the  Glosso-Pharyngeal, 
but  behind  that  nerve. 

Accessorius.  — The  Spinal  Accessory  nerve  arises  by  nu- 
merous filaments  from  the  Medulla  Oblongata  and  Me- 
dulla Spinalis. 

9-  Hypo  glossus.  — The  Hypoglossal  nerve  arises  in  the  fissure 
between  the  Corpus  Pyramidale  and  the  Corpus  Olivare. 


CRANIAL  NERVES. 

Course  and  Distribution. 

I.  OLFACTORIES. 

V* 

PLATE  II.,  FIG.  1. 

It  passes  forwards  from  its  root  on  the  under  surface  of  the  anterior 
lobe  of  the  brain,  and  converges  gradually  towards  its  fel- 


WL 


T.  SJDuval,  Lith  Fhilx 


THE  NERVES. 


11 


low,  so  as  to  reach  the  cribriform  plate  of  the  ethmoid 
bone.  The  anterior  extremity  is  enlarged  into  what  is 
called  the  Bulb,  from  which  proceed  filaments  which  pe- 
netrate into  the  nose  through  the  perforations  of  the  Cri- 
briform plate,  and  spread  themselves  on  the  Schneiderian 
membrane.  It  is  exceedingly  soft  and  pulpy  in  its  whole 
length. 

II.  OPTICUS. 

PLATE  II.,  FIG.  2. 

The  optic  is  a large  and  flattened  nerve,  which  passes  forwards 
and  inwards  in  front  of  the  tuber  cinereum,  joining  its  fel- 
low and  forming  the  Chiasm , which  resembles  the  letter  X. 
It  afterwards  penetrates  the  orbit,  through  the  Foramen 
Opticum  of  the  sphenoid  bone,  and  joins  the  retina  of  the 
eye. 

III.  MOTOR  OCULI. 

Plate  ii. , fig.  3. 

This  nerve  proceeds  from  its  origin  towards  the  external  margin 
of  the  cavernous  sinus;  and,  penetrating  into  the  orbit, 
through  the  Sphenoidal  Foramen,  it  divides  into  two  large 
branches,  which  are  distributed  to  most  of  the  muscles  of 
the  eye-ball.  It  also  sends  a short  branch  into  the  poste- 
rior margin  of  the  Lenticular  or  Ophthalmic  ganglion. 
This  ganglion  is  situated  at  the  outer  side  of  the  optic 
nerve,  in  the  orbit  of  the  eye,  and  is  about  one  line  in 
diameter,  being  flattened.  Two  nerves  concur  to  form  it 
— the  branch  just  alluded  to  from  the  3d  pair,  or  Motor 
Oculi,  and  the  Ramus  Ciliaris,  which  comes  from  the 
Ophthalmic  branch  of  the  5th,  or  Trigeminus.  From  this 
ganglion  arise  most  of  the  ciliary  nerves,  which  are  about 


12 


OUTLINES  OF 


20  in  number,  and  are  spent  upon  the  choroid  coat  of  the 
eye  and  the  iris. 

IV.  PATHETICUS. 

PLATE  II.,  FIG.  3. 

The  Trochlearis  or  Pathetic  is  the  smallest  cranial  nerve,  being 
not  larger  than  a sewing  thread.  Having  got  into  its  canal 
of  dura  mater,  it  passes  through  the  Cavernous  Sinus,  and 
then  enters  the  orbit  through  the  Sphenoidal  Foramen.  It 
is  distributed  upon  the  superior  oblique  muscle  of  the  eye, 
having  entered  it  near  its  middle. 

V.  TRIGEMINUS. 

PLATE  III. 

* 

This  is  one  of  the  largest  nerves  ; it  has  formed  upon  it,  in  a canal 
of  dura  mater,  a large  ganglion,  called  the  Ganglion  of 
Casser,  and  then  divides  into  three  large  trunks  called 

, Ophthalmic,  Superior  Maxillary,  and  Inferior  Maxillary 

Nerves. 

1.  OPHTHALMIC. — The  first  branch  of  the  Trigeminus  passes 
through  the  Cavernous  Sinus,  and  enters  the  orbit  through 
the  sphenoidal  foramen.  While  in  this  foramen  it  divides 
into  three  branches,  called  Nasal,  Frontal,  and  Lachrymal. 

The  Nasal  branch  of  the  Ophthalmic  ascends  towards  the  internal 
face  of  the  orbit.  It  gives  off  a branch  called  Ramus  Ci- 
liaris,  which  joins  the  Lenticular  Ganglion,  which  was 
referred  to  in  the  description  of  the  third  pair.  Afterwards 
it  gives  off  a branch  called  Internal  JVasal , which  enters 
the  cavity  of  the  cranium  through  the  anterior  orbitary 
foramen,  and  then  passes  into  tire  nose,  through  the  most 


Aerves 


FI  ate  3? 


WL.de/. 


F.S.Fui/al, L itk  Fhil  * 


THE  NERVES. 


13 


anterior  perforation  of  the  cribriform  plate,  descending  in 
a groove  upon  the  under  surface  of  the  nasal  bone  to  the 
Schneiderian  membrane.  The  remainder  of  this  nerve  is 
spent  upon  the  muscles,  eye-lids,  conjunctiva,  &c. 

The  F ro  nt  a 1 is  the  largest  branch  ofthe  Ophthalmic.  It  divides 
into  two  filaments,  one  of  which  emerges  from  the  orbit 
through  the  super-orbitary  foramen,  and  the  other  passes 
out  near  the  trochlea.  It  supplies  the  muscles  and  integu- 
ments of  the  forehead  and  scalp. 


The  Lachrymal  traverses  the  external  side  of  the  orbit  and  sup- 
plies the  lachrymal  gland.  It  sends  some  filaments  also 
to  the  surrounding  structures. 


2.  SUPERIOR  MAXILLARY.  — This  nerve  leaves  the  Ganglion  of 
Tjjiasser,  and,  passing  through  the  Foramen  Rotundum  of 
the  Sphenoid  Bone,  enters  the  pterygo-maxillary  fossa.  It 
divides  into  two  large  branches,  called  Infra-orbital  and 
Pterygo-palatine. 


M, 


The  Infra-orbital  passes  forwards,  and  gives  ofFa  branch  called 
Posterior  dental , which  supplies  three  molar  teeth,  and  a 
part  of  the  antrum  and  the  gums.  The  infra-orbital,  in  its 
course  through  the  canal,  sends  off  anterior  dental  nerves 
to  the  remaining  teeth  and  gums.  It  emerges  at  the  infra- 
orbitar  foramen  of  the  superior  maxillary  bone,  being  di- 
vided into  numerous  filaments  which  supply  the  skin  and 
muscles  of  the  face. 


The  Ptery  go-palatilie  descends  as  a single  or  double  trunk  to  the 
outside  of  the  spheno- palatine  foramen,  and  there  forms  the 
Ganglion  of  Meckel,  from  which  proceed  several  branches, 
viz.,  the  Sfxeno- palatine  branches,  which  enter  the  nose 
through  the  Spheno-Palatine  Foramen  ; one  of  which  is 
exceedingly  long,  and  called  JSTaso- Palatine,  it  descends 


14 


OUTLINES  OF 


through  the  Foramen  Incisivum  to  the  roof  of  the  mouth, 
where,  with  its  fellow,  it  forms  the  Naso-palatine,  or  Clo- 
quet’s ganglion,  Plate  n.,  Fig.  1. 

"t-4 

The  Posterior  palatine  nerve  descends  from  Meckel’s  ganglion 
through  the  posterior  palatine  foramen  to  the  Palate  and 
Fauces.  Some  suppose  this  nerve  sends  a branch  along 
the  roof  of  the  mouth  to  the  Naso-palatine  Ganglion. 

The  Vidian  or  Pterygoid  or  Recurrent  nerve  proceeds  backwards 
from  Meckel’s  ganglion  through  the  Pterygoid  foramen  of 
the  Sphenoid  bone.  While  in  this  foramen  it  divides  into 
two  trunks  called  the  Superficial  Petrous  and  the  Deep 
Petrous,  which  enter  the  cavity  of  the  cranium  through  the 
Anterior  Foramen  Lacerum. 

The  Superficial  Petrous  traverses  a gutter  on  the  superior  surface 
of  the  Petrous  bone,  and  disappears  through  the  Vidian 
Foramen  or  Hiatus  Fallopii.  It  adheres  to  the  Facial 
nerve  in  the  aqueduct  of  Fallopius,  after  leaving  which,  it 
traverses  the  tympanum,  and  receives  the  name  of  Chorda 
Tympani:  it  then  emerges  at  the  glenoid  fissure  or  fora- 
men, and,  descending,  joins  the  Gustatory  nerve,  with 
which  it  continues  until  it  reaches  the  Submaxillary 
ganglion. 

The  Deep  Petrous  enters  the  carotid  canal,  and  anastomoses  there 
with  the  branch  of  the  Motor  Externus,  or  sixth  pair,  around 
the  internal  carotid  artery  to  form  the  ganglion  of  Laumo- 
nier,  which  is  usually  considered  as  the  origin  of  the  sym- 
pathetic nerve. 

S.  INFERIOR  MAXILLARY  — Is  the  third  branch  of  the  trigemi- 
nus, and  is  the  largest  of  the  three.  It  escapes  from  the 
cranium  through  the  foramen  ovale  of  the  sphenoid  bone, 
and  divides  into  anterior  and  posterior  branches.  The 


THE  NERVES. 


15 


anterior  branches  are  spent  upon  the  Masseter,  Temporal, 
Buccal,  and  Pterygoid  muscles.  The  Posterior  consists  of 
the  Lingual  or  Gustatory,  Inferior  dental,  and  Superficial 
Temporal  nerves. 


j i ii  s h l after  receiving  the  chorda  tympani  at  an  acute  angle, 
between  the  pterygoid  muscles,  enters  the  side  of  the  root 
of  the  tongue. 


The  Submaxillary  Ganglion  is  formed  of  filaments  from  the 
lingual  nerve  and  chorda  tympani.  The  branches  from 
this  ganglion  are  distributed  to  the  Submaxilla’ry  gland,  &c. 
The  Lingual  or  Gustatory  nerve  supplies  the  papillae  upon 
the  anterior  portion  of  the  tongue. 

Inferior  Dental  descends  between  the  Pterygoid  muscles  and 
enters  the  Posterior  Mental  Foramen  of  the  Lower  Jaw. 
While  traversing  the  jaw,  it  sends  numerous  branches  to 
the  teeth  and  gums  ; and  a large  branch,  called  Mental , 
comes  out  at  the  Anterior  Mental  Foramen,  which  is 
distributed  to  the  chin  and  lower  lip. 


Superficial  Temporal  is  formed  by  a union  of  fasciculi  from  the 
Lingual  and  Inferior  Dental.  It  passes  outwardly,  giving 
branches  to  the  Parotid  gland,  and  afterwards,  in  company 
with  the  Temporal  Artery,  is  distributed  to  the  integuments 
on  the  side  of  the  head. 


VL  MOTOR  EXTERNUS. 

PLATE  II.,  FIG.  3. 

This  nerve,  when  passing  through  the  cavernous  sinus,  sends  a 
branch  to  form  the  ganglion  of  Laumonier  with  the  Deep 
Petrous  nerve  in  the  carotid  canal,  after  which  it  enters  the 


16 


OUTLINES  OF 


orbit  through  the  sphenoidal  foramen,  and  is  distributed 
entirely  upon  the  external  rectus  muscle. 

VII.  FACIALIS  ET  AUDITORIUS. 

PLATE  IV. 

The  seventh  pair  consists  of  two  principal  trunks  — the  Facial  or 
Portio  Dura,  and  Auditory  or  Portio  Mollis. 

THE  FACIAL,  OR  PORTIO  DURA,  leaves  the  cavity  of  the  cra- 
nium by  entering  the  Internal  Meatus  Auditorius  of  the 
temporal  bone,  in  which  it  is  accompanied  for  a short  dis- 
tance by  the  deep  petrous  which  becomes  the  Chorda 
Tympani  nerve.  It  escapes  from  the  temporal  bone  at  the 
stylo-mastoid  foramen,  and  assumes  a radiated  form,  to 
which  the  name  of  Pes  Anserina  is  given,  the  filaments  of 
which  are  denominated  as  follow  : 

Post-Auricular.  — This  extends  from  the  Stylo-mastoid  F ora- 
men  to  behind  the  centre,  supplying  the  muscles,  integu- 
ments, &c.  It  also  sends  off  anastomotic  branches  down- 
wards. 

The  Facial  then  penetrates  the  Parotid  Gland,  in  which  it  divides 
into  several  branches  ; several  of  which  are  called 

Temporo- facial.  — These  are  distributed  to  the  muscles  on  the 
upper  part  of  side  of  the  head. 

Buccal.  — These  are  three  in  uumber  and  supply  the  muscles  of 
the  cheek. 


Cervicofacial. — This  branch  descends  to  join  the  anastomosis 
formed  by  the  three  superior  cervical  nerves,  frequently 
called  Cervical  Plexus.  The  Facial  nerve  is  said  not  to 
supply  the  skin. 


J^erves 


Plate  -f 


th 


IP.  S.Lii>val Isith.jPhii*' 


THE  NERVES. 


17 


AUDITORY  OR  PORTIO  MOLLIS.  — This  nerve  enters  the 
Meatus  Auditorius  Internus  with  the  Portio  dura.  It  is 
distributed  to  the  Labyrinth,  &c.,  of  the  Internal  Ear. 
Refer  to  Plate  IV.,  Fig.  2. 

VIII.  GLOSSO-PHARYNGEAL,  PNEUMOGASTRIC,  AND 
SPINAL  ACCESSORY. 

PLATE  V. 

\ 

The  Eighth  nerve  escapes  from  the  cavity  of  the  cranium  through 
the  posterior  foramen  lacerum,  in  company  with  the  In- 
ternal Jugular  vein  from  which  it  is  separated  by  a small 
spine  of  bone.  It  consists  of  three  principal  trunks,  viz.  : 

GLOSSO-PHARYNGEAL.  — This  nerve,  after  leaving  the  base  of 
the  cranium,  is  separated  from  the  Pneumogastric  by  the 
Internal  Jugular  vein.  It  is  directed  downwards  and  for- 
wards between  the  Internal  Carotid  Artery  and  the  Stylo- 
Pharyngeus  muscle,  afterwards  between  the  latter  and  the 
Stylo-Glossus  muscle  : it  accompanies  the  latter  to  the  side 
of  the  root  of  the  Tongue.  It  supplies  the  Papillae  of  the 
base  of  the  Tongue,  the  Tonsils,  and  Soft  Palate.  It  also 
sends  branches  to  the  muscles  of  the  Tongue  and  Pharynx, 
and  to  the  Pharyngeal  Plexus  of  the  Sympathetic  and 
Pneumogastric  nerves. 

PNEUMOGASTRIC.  — This  nerve  is  frequently  called  Par-vagum , 
and  is  closely  united  to  the  other  branches  of  the  eighth 
pair  and  ninth  pair,  after  its  exit  from  the  cranium.  It 
descends  the  neck  between  the  Internal  Carotid  Artery  and 
the  Internal  Jugular  vein,  and  is  enveloped  in  their  sheath. 
At  the  root  of  the  neck,  upon  the  right  side,  it  passes  in 
front  of  the  Subclavian  Artery,  but  on  the  left,  it  crosses  the 
root  of  the  Subclavian  and  the  arch  of  the  Aorta.  It  is 
then  directed  backwards  and  downwards  into  the  cavity 
of  the  Thorax,  and  becomes  connected  with  the  root  of  the 
3 


18 


OUTLINES  OF 


Lung,  after  which  it  applies  itself  to  the  (Esophagus,  and 
follows  it  through  the  Diaphragm  to  the  Stomach  : the  Par- 
vagum  of  the  left  side  is  on  the  anterior  surface  of  the 
(Esophagus,  and  that  of  the  right  side  on  its  posterior  sur- 
face. It  gives  off  three  sets  of  branches,  viz.  : Cervical, 
Thoracic  and  Abdominal. 

Cervical  Branches.  — These  are  in  the  Neck,  and  are  three 
in  number. 

The  Superior  Pharyngeal.  — It  anastomoses  with  the  Glosso- 
pharyngeal and  forms  the  Pharyngeal  Plexus  on  the  mid- 
dle constrictor  of  the  Pharynx.  A filament  called  Infe- 
ferior-Pharyngeal  sometimes  arises  from  the  Par-vagum, 
below  the  Superior,  and  is  spent  upon  the  Pharynx.  There 
is  an  enlargement  and  softening  of  the  Par-vagum  nerve 
at  the  origin  of  the  Pharyngeal  branches,  which  is  called 
the  Gangli/orm  Plexus. 

Superior  Laryngeal.  — It  arises  from  the  Gangliform  Plexus,  anas- 
tomosing the  Pharyngeal  Plexus,  &c.,  and  divides  into 
two  branches,  which  supply  the  Mucous  Membrane  of 
the  Larynx  and  Vocal  muscles. 

In  its  descent,  the  Par-vagum  gives  off,  at  the  lower  part  of  the 
neck,  two  or  three  filaments  called  Rami  Cardiaci.  These 
reach  the  arch  of  the  Aorta  and  anastomose  with  the  Su- 
perficial Cardiac  nerve. 

Inferior  Laryngeal.  — This  is  often  called  Recurrent  Laryngeal. 
On  the  right  side  it  arises  from  the  Par-vagum  after  the 
trunk  has  passed  in  front  of  the  Subclavian  Artery.  It  then 
winds  around  the  Subclavian,  forming  a loop  : upon  the 
left  side  it  forms  a loop  around  the  Aorta.  Ascending 
upon  the  side  of  the  Trachea  and  Larynx,  it  is  distributed 
to  its  muscles.  It  also  gives  off  branches  called  Cardiac, 
Pulmonary , (Esophageal,  &c. 


THE  NERVES. 


19 


Thoracic  Branches.  — These  branches  of  the  Par-vagum  are 
the  Tracheal , which  form 

The  Anterior  Pulmonary  Plexus.  — from  which  branches  are  sent 
to  the  Lung  along  the  course  of  the  Pulmonary  Artery. 

The  Posterior  Pulmonary  Plexus  — is  formed  by  several  filaments 
of  the  Par-vagum  and  Sympathetic.  Its  branches  pass 
through  the  Lung  along  with  the  Bronchial  tubes,  and  are 
distributed  to  its  mucous  membrane  and  glands. 

Abdominal  Branches.  — The  Par-vagum  of  the  right  and  left 
sides  form  a plexus  around  the  cardiac  orifice  of  the  sto- 
mach. The  right  nerve  is  then  distributed  along  the  lesser 
curvature  and  posterior  face  of  the  stomach,  anastomosing 
with  the  gastric  plexus  and  solar  plexus.  The  left  sup- 
plies the  anterior  face  of  the  stomach  and  its  lesser  curva- 
ture, anastomosing  with  the  nerve  of  the  right  side  and 
gastric  and  solar  plexuses. 

SPINAL  ACCESSORY.  — The  Accessory  nerve  is  directed  out- 
wards and  backwards,  and  divides  into  two  branches. 
The  internal  branch  gives  filaments  to  the  superior  pha- 
ryngeal nerve.  The  external  descends  for  about  two 
inches  behind  the  internal  jugular  vein,  and  afterwards 
pierces  the  sterno-cleido-mastoid  muscle  at  the  junction  of 
its  upper  and  middle  thirds.  It  is  augmented  by  branches 
from  the  second  and  third  cervical  nerves,  and  is  distri- 
buted by  numerous  filaments  to  the  trapezius  muscle. 

IX.  HYPOGLOSSAL. 

PLATE  V. 

This  nerve  adheres  for  an  inch  to  the  pneumogastric  nerve.  It 
crosses  the  external  carotid  artery,  just  below  the  origin  of 
the  occipital  artery,  making  a large  curve  below  the  di- 
gastric muscle,  and  ascends  to  the  tongue,  being  concealed 


20 


OUTLINES  OF 


by  the  mylohyoid  muscle.  As  it  crosses  the  carotid  artery, 
it  sends  off  a large  branch  called  Descendens  Noni , which 
descends  upon  the  sheath  of  the  vessels  upon  the  neck, 
anastomosing  with  the  cervical  nerves,  and  then  supplies 
the  sterno  muscles.  The  hypoglossal  nerve  is  distributed 
to  the  muscles  of  the  tongue. 

SYMPATHETIC  NERVE. 

PLATE  VI. 

This  nerve  consists  of  a chain  of  ganglions  placed  upon  the  sides 
of  the  bodies  of  the  vertebras,  extending  from  the  base  of 
the  cranium  to  the  end  of  the  sacrum.  They  are  united 
to  each  other  by  filaments,  and  also  to  the  anterior  trunks 
of  the  spinal  nerves.  The  origin  of  the  sympathetic  nerve 
is  generally  described  as  the  ganglion  of  Laumonier,  which 
is  formed  in  the  carotid  canal  by  a branch  of  the  fifth  pair, 
called  Deep  Petrous,  with  a branch  of  the  sixth  pair,  or 
Motor  Externus.  The  anastomosis  of  Jacobson  shows  the 
sympathetic  to  be  from  the  ganglion  of  Ribes,  which  is 
formed  upon  the  anterior  communicating  artery  in  the 
middle  of  the  base  of  the  brain.  This  anastomosis  is 
exhibited  in  Plate  VI.,  Fig.  2.  The  ganglions  of  the  sym- 
pathetic are  placed  opposite  the  intervertebral  spaces 
throughout  the  spine,  with  the  exception  of  those  of  the 
neck,  which  are  but  three  in  number,  viz. : 

SUPERIOR  CERVICAL  GANGLION.  — Varies  considerably  in  its 
size  and  extent,  commencing  opposite  the  second  vertebrae, 
and  reaching  to  the  third  or  fourth.  It  sends  off  branches 
of  a reddish  colour,  which  are  extremely  soft,  and  hence 
are  called  JVervi  Molles.  These  are  divided  into  Superior, 
Middle,  and  Inferior.  The  Inferior  form  by  their  union  a 
cord  called  the  Superficial  Cardiac  Nerve , which  descends 
along  the  neck,  and  is  lost  in  the  middle  cardiac  nerve 
and  contiguous  anastomoses. 


/Verves 


Plate  6‘V 


Sympathetic 


Ant.  Commiuvi:  Artery 
,{  (rcaiption.  of  Hikes 


‘ 2fasaL  branch,  of  Opthalmic 


E S.IjzuuzS,  XUh.  Fhirv 


W.I.chU. 


. 


THE  NERVES 


21 


MIDDLE  CERVICAL  G A N G L I 0 N . — Is  placed  between  the  fifth 
and  sixth  cervical  vertebrae,  upon  the  Longus  Colli  muscle. 
It  sends  off  numerous  filaments,  some  of  which  collect  into 
a cord,  which  is  called  the  Middle  Cardiac  JYerve,  which 
anastomoses  with  Superficial  Cardiac  and  Pneumogastric, 
and  extends  to  the  Cardiac  Plexus. 

INFERIOR  CERVICAL  GANGLION  — Is  situated  near  the  head 
of  the  first  rib,  and  varies  in  form  and  size.  Its  branches 
are  numerous,  some  of  which  collect  into  a cord,  and  form 
the  Inferior  Cardiac  nerve,  which  is  blended  with  the 
Cardiac  Plexus  on  the  right  side,  and  with  the  Middle 
Cardiac  nerve  on  the  left.  The  Cardiacs  of  the  right  side 
are  more  constant  than  those  of  the  left. 

CARDIAC  PLEXUS. 

Is  situated  between  the  arch  of  the  aorta  and  the  bifurcation  of  the 
trachea.  It  is  formed  by  branches  from  the  three  cervical 
ganglions  of  each  side  of  the  neck,  but  principally  from 
the  Middle  Cardiac  Nerves.  It  is  also  joined  by  filaments 
from  the  par-vagum,  and  inferior  laryngeal.  The  branches 
of  the  Cardiac  Plexus  are  divided  into  Anterior,  Posterior, 
and  Inferior.  The  Anterior  and  Posterior  branches  are 
spent  about  the  roots  of  the  large  vessels.  The  Inferior 
branches  are  the  largest  and  most  abundant ; and  are 
arranged  into  two  Plexuses,  called  Anterior  and  Posterior 
Coronary,  from  which  filaments  are  distributed  to  the  auri- 
cles and  ventricles  of  the  heart. 

THORACIC  GANGLIONS  OF  THE  SYMPATHETIC. 

These  are  twelve  in  number,  placed  at  the  intervertebral  spaces, 
near  the  heads  of  the  ribs.  They  are  united  to  each  other 
and  to  the  spinal  nerves.  Filaments  from  the  sixth  to 
the  ninth  or  tenth  ganglions  inclusively,  form  the  great 
Splanchnic  JYerve , which  is  directed  downwards,  and 


22 


OUTLINES  OE: 


enters  the  abdomen  at  or  near  the  foramen  aorticum  of  the 
diaphragm.  Whilst  in  the  abdomen  it  divides  into  fasci- 
culi ; upon  which  are  formed  the  small  ganglions  which 
are  arranged  in  a crescentic  manner,  and  called  the  Semi- 
lunar Ganglion. 

Small  Splanchnic  N c r v e is  formed  by  filaments  of  the  tenth 
and  eleventh  Thoracic  Ganglions.  It  reaches  the  abdo- 
men by  penetrating  the  crus  of  the  diaphragm,  and  then 
divides  into  two  branches,  one  of  which  joins  the  great 
splanchnic  and  the  other  descends  to  the  Renal  Plexus. 

SOLAR  PLEXUS. 

* 

The  origin  of  the  Solar  Plexus  may  be  considered  to  be  the  Semi- 
Lunar  Ganglion.  This  ganglion  is  semicircular  or  oval, 
is  about  an  inch  in  length,  and  is  placed  on  the  side  of  the 
aorta,  it  is  composed  of  smaller  ganglions,  formed  upon 
filaments  of  the  splanchnic  nerves.  From  it  proceeds  the 
Solar  Plexus,  which  extends  along  the  aorta  to  the  cceliac 
and  to  the  emulgent  artery,  and  is  common  to  both  sides. 
From  it  are  derived  several  smaller  plexuses,  accompa- 
nying the  large  arterial  trunks,  from  which  these  several 
intertextures  derive  their  names  ; — for  instance,  the  He- 
patic Plexus , supplying  the  liver,  gall-bladder,  &c.,  sur- 
rounding the  Hepatic  Artery.  The  Splenic  Plexus  sur- 
rounding the  Splenic  Artery  supplies  the  Spleen.  The 
Superior  Mesenteric  — Renal , Inferior  Mesenteric,  &c. 

HYPOGASTRIC  PLEXUS. 

PLATE  VI. 

Is  situated  in  the  lower  part  of  the  pelvis,  and  is  formed  by 
filaments  form  the  lumbar  ganglions  through  the  Inferior 


THE  NERVE8. 


23 


Mesenteric  Plexus,  and  by  means  of  filaments  from  the 
Sacral  ganglions,  which  are  usually  three  in  number.  This 
plexus  is  distributed  upon  the  rectum  and  bladder,  organs 
of  generation,  &c.  The  last  sacral  ganglion  anastomoses 
with  its  fellow,  forming  an  arch  upon  the  front  of  the  coc- 
cyx, whose  convexity  is  downwards,  and  which  terminates 
the  sympathetic  nerve. 

SPINAL  NERVES. 

These  are  usually  thirty  in  number,  and  are  divided  into  1 sub- 
occipital,  7 cervical,  12  dorsal,  5 lumbar,  and  5 sacral. 
Each  arises  by  two  roots  from  the  spinal  marrow,  which 
unite  in  the  intervertebral  foramen.  Before  their  union, 
an  oval  ganglion  is  formed  upon  the  posterior  and  larger 
root.  After  their  union,  they  divide  into  posterior  and 
anterior  trunks.  Plate  VII.,  Fig.  2.  The  sacral  ganglions 
are  in  the  spinal  canal. 

SUB-OCCIPITAL  NERVE.  — This  nerve  is  exceedingly  small, 
and  generally  arises  by  a single  root  from  the  spinal  mar- 
row. It  passes  out  of  the  vertebral  cavity  between  the 
occiput  and  the  atlas,  and  supplies  the  muscles  on  the 
back  of  the  neck  and  head.  Plate  VI.  and  Plate  IV., 
Fig.  1. 

THREE  SUPERIOR  CERVICAL  NERVES.  — After  escaping 
through  the  intervertebral  foramina,  they  divide  into  ante- 
rior and  posterior  trunks.  The  posterior  trunks  are  spent 
upon  the  muscles  of  the  spinal  column.  The  anterior 
trunks  form  a Plexus,  branches  from  which  supply  the 
muscles  of  the  neck  and  cutaneous  branches  which  are 
distributed  to  the  integuments,  and  an  Auricular  branch 
which  passes  behind  the  ear. 

PHRENIC  NERVE.  — This  nerve  is  formed  from  the  second  and 
third  cervical,  descends  upon  the  front  of  the  scalenus 


24 


OUTLINES  OF 


anticus  muscle,  and  then  enters  the  thorax  through  the 
superior  mediastinum  ; passing  over  the  pericardium  is  dis- 
tributed to  the  diaphragm. 

FOUR  INFERIOR  CERVICAL  NERVES.  Plate  VII. —The 
posterior  branches  are  distributed  to  the  muscles  of  the  head 
and  back.  The  anterior  branches  are  larger,  and  descend 
between  the  scalenus  anticus  and  scalenus  medius  mus- 
cles, above  the  subclavian  artery,  to  form  the  brachial 
plexus. 

BRACIIIAL  OR  AXILLARY  PLEXUS. — This  plexus  is  formed 
by  the  junction  of  the  four  inferior  cervical  nerves,  and  the 
first  dorsal,  and  extends  from  the  scaleni  muscles  to  the 
neck  of  the  humerus,  surrounding  the  axillary  artery.  It 
gives  off  the  following  nerves,  viz.  : 


Scapular.  — It  passes  backwards  over  the  shoulder,  through  the 
coroc.oid  notch  of  the  scapula,  and  is  distributed  to  the 
spinati  muscles. 


Subscapular . — These  are  usually  three  in  number.  They  are  dis- 
tributed to  the  subscapularis,  teres,  and  serratus  anticus 
muscles. 

Thoracic.  — These  are  two  in  number,  are  distributed  to  the  sub- 
clavius  and  pectoralis  minor  and  major  muscles  and 
integuments. 

Axillary  or  Circumflex.  — It  descends  and  winds  around  the 
head  of  the  os  humeri,  running  with  the  posterior  circum- 
flex artery,  and  is  distributed  to  the  deltoid  muscle. 


^Verves 


Plate  7*. 


WTZ.deL 


Fig.  / 


Fig.  Z. 


.Post  Trusi/c 


- . Ant.  TrccnJi 


Section,  of  Spinal  r/iarrotu. 


P S.  DilvcU'j Litt-K Phila 


> 


THE  NERVES. 


25 


Internal  Cutaneous.  — Is  a small,  thin  nerve,  descending  the 
arm,  dividing  into  several  branches  at  the  elbow,  and  is 
distributed  to  the  integuments.  Some  of  the  branches 
reach  the  hand. 

Musculo- Cutaneous  or  External  Cutaneous.  — It  descends  and 
perforates  the  coraco  brachialis.  At  the  elbow  it  divides 
into  several  branches,  supplying  the  muscles  of  the  arm, 
and  the  integuments  of  the  fore-arm  and  hand. 

Radial  or  Musculo- Spiral.  — This  is  very  large,  and  winds  spi- 
rally around  the  humerus,  passing  between  the  first  and 
third  heads  of  the  triceps  muscle,  making  its  appearance 
near  the  external  condyle.  It  divides  into  three  principal 
trunks  — Superficialis,  Anterior  and  Posterior,  and  Pro- 
fundus Dorsalis.  They  are  distributed  to  the  muscles  of 
the  arm,  fore-arm,  and  hand. 

Median  Nerve.  — This  is  one  of  the  largest  branches  of  the  Bra- 
chial Plexus.  It  descends  on  the  inside  of  the  biceps 
muscle,  firmly  adhering  to  the  brachial  artery.  It  then 
passes  between  the  two  heads  of  the  pronator  teres  muscle, 
and,  descending  the  fore-arm  between  the  flexor  sublimis 
and  flexor  longus  pollicis  muscle,  it  passes  under  the 
annular  ligament  of  the  wrist,  terminating  in  branches 
which  supply  each  side  of  the  thumb  and  fingers,  with  the 
exception  of  the  little  finger  and  the  ulnar  side  of  the  ring 
finger. 

Ulnar.  — It  descends  the  arm  upon  the  anterior  part  of  the  triceps 
muscle,  and  passes  under  the  internal  condyle,  where  it  is 
quite  superficial.  It  gives  off  several  branches,  which 
supply  the  muscles  of  the  fore-arm,  and  passing  over  the 
annular  ligament  of  the  wrist,  it  sends  branches  to  each 
side  of  the  little  finger,  and  to  the  ulnar  side  of  the  ring 
finger. 

4 


26 


OUTLINES  OF 


DORSAL  NERVES.  — The  posterior  .branches,  are  distributed  to 
the  muscles  of  the  back,  and;  the  anterior  branches  gene- 
rally accompany  the  intercostal  vessels  in  the  groove  at 
the  inferior  edge  of  each  rib.  They  are  spent  upon  the 
abdominal  muscles  and  integuments.  The  first  joins  the 
axillary  plexus,  the  second  and  third  give  off  two  branches 
called  Intercosto-Humeral,  or  nerves  of  Wrisberg  which 
are  distributed  to  the  integuments  of  the  axilla  and  arm. 
The  twelfth  sends  a branch  to  join  the  first  lumbar. 

LUMBAR  AND  SACRAL  NERVES.  — The  posterior  branches 
are  spent  upon  the  muscles  of  the  loins  and  back ; the 
anterior  branches  form  a large  plexus  called  Crural,  which 
is  divided  into  two  parts  called  Lumbar  and  Ischiatic. 

■ : J’  ■iiii  it  2i ..'O 

LUMBAR  PLEXUS, 

Is  formed  by  four  superior  lumbar  nerves  ; is  concealed  by  the 
psoas  magnus  musele,-andgives  off  the  following  branches, 
viz. 

Abdomino-  Crural.  — These  are  three  in  number  ; they  arise  from 
the  upper  part  of  the  plexus,  and  descend  obliquely  over 
the  quadratus  lumborum  muscle  towards  the  crista  of  the 
ilium.  They  send  branches  to  the  abdominal  muscles 
and  through  the  rings  to  the  pubis,  and  also  send  fila- 
ments to  the  integuments  of  the  hip  and  thigh. 

External  Spermatic  penetrates  the  psoas  magnus  muscle,  upon 
which  it  descends.  It  sends  branches  to  the  groin  and 
cremaster  muscle. 

External  Cutaneous  passes  obliquely  outwards  over  the  iliacus 
internus  muscle  towards  the  anterior  superior  spinous 
process  of  the  ilium,  and,  penetrating  Poupart’s  ligament, 
is  distributed  to  the  integuments  of  the  outer  portion  of 
the  thigh. 


J\  eri-es 


Mate  & ^ 


G&tto 

~&&&arrrmo 


Pjfj-  QOlS&L 


tP..)'.LueuJ.JLLiJi..Phila 


TV Z. del. 


THE  NERVES. 


27 


Anterior  Crural.  — Is  the  largest  branch  arising  from  the 
lumbar  plexus.  It  passes  beneath  the  psoas  magnus  mus- 
cle, and  emerges  from  the  abdomen  under  Poupart’s  liga- 
ment, about  half  of  an  inch  from  the  outside  of  the 
femoral  artery.  It  gives  off  several  branches. 


Cutaneous  Medius — ‘Arises  from  the, , eppterior  crural,  about  an 
inch  above  Poupart’s  ligament : descending,  it  penetrates 
the  Sartorius  Muscle,  and  is  distributed  to  the  integu- 


ments. 


Anterior  Cutaneous  ■ 


to 


;;  - J ' •** 

Arises  from  the  interior 


ral,  penetrates 

the  fascia  of  the  thigh,  and  is  distributed  to  the  integu- 


(-'j-io 


ments. 


o !-1  isi'i.yi  >. 


Internal  Cutaneous  — Is  another  one  of  the  same  cluster,'  arising 
from  the  Anterior  Crural,  aboVe  Poupart’s  ligament,  and 
is  distributed  to  the  integuments  on  the  inside  of  the 
thigh. 


•<*  ,•  m 'tj 
‘iltsiu- JSi  i 


Saphenus  — Is  a filament  of  the  Anterior  Crural  which  accompa- 
nies the  femoral  artery  till  it  perforates  the  adductor  mag- 
nus. It  then  attaches  itself  to  the  saphena  major  vein,  and 
is  distributed  to  the  integuments  upon  the  inner  side  of 
the  leg  and  foot. 

~ " .Si  of 

Obturator.  — Is  derived  from  the  lumbar  plexus, and  descends 
into  the  pelvis,  from  beneath  the  psoas  magnus  muscle. 
It  then  passes  forward  through  the  obturator  foramen,  and 
dividing  into  two  branches  is  distributed  to  the  adductor 
muscles  of  the  thigh.  1 


SCIATIC  PLEXUS.  r 


This  plexus  is  formed  by  the  juhetion  of  the  last  Lumbar  and  the 
four  Superior  Sacral  nerves.  It  is  situated  in  the  back 


28 


OUTLINES  OF 


portion  of  the  pelvis,  and  in  front  of  the  Pyriformis  Muscle. 
The  fifth  and  sixth  — if  the  latter  should  exist  — are  dis- 
tributed to  the  muscles  about  the  anus.  This  plexus  gives 
off  the  following  branches  : 

Gluteal.  — These  are  two  in  number;  one  passes  out  of  the 
Sciatic  notch,  above  the  Pyriform  Muscle,  and  the  other 
below  it.  They  are  distributed  to  the  Glutsei  Muscles. 

Superior  Long  Pudendal.  — It  accompanies  the  Internal  Pudic 
artery,  between  the  two  Sacro-Sciatic  ligaments,  and  is 
distributed  to  the  Perinseum  and  organs  of  generation. 

Inferior  Long  Pudendal  — Passes  under  the  tuber  of  the  Ischium, 
and  is  distributed  to  the  Gluteeus  Maximus,  and  to  the 
external  parts  of  the  organs  of  generation. 

Posterior  Cutaneous  — Is  given  off  from  the  plexus  in  common 
with  the  Inferior  Pudendal ; descends  the  back  of  the 
thigh,  and  is  distributed  to  the  skin  and  Superficial 
Fascia. 

SCIATIC  OR  ISCIIIATIC.  — Is  the  largest  nerve  in  the  body. 
It  escapes  from  the  Pelvis  through  the  Sacro  Sciatic 
notch,  above  the  ligaments  and  between  the  Pyriformis 
and  Geminus  Superior  Muscles.  It  descends  the  back  of 
the  thigh  beneath  the  Biceps  Flexor  Cruris  muscle,  and 
below  the  middle  divides  into  two  large  trunks,  called 
Peroneal  and  Popliteal ; previous  to  which,  however,  it 

gives  off  several  cutaneous  and  muscular  branches  of  small 
size. 

Peroneal  — Extendsjfrom  the  bifurcation  of  the  Sciatic,  towards 
the  External  Condyle,  and  gives  off  the  two  following 
branches  : 


erves. 


1? S.DiUL/aZ^itJi.PhiC0 


WTL.det. 


THE  NERVES. 


29 


External  Peroneo-  Cutaneous  — Is  spent  upon  the  skin  over  the 
fibula. 

Internal  Peroneo-  Cutaneous  — Descends  under  the  external  head 
of  the  Gastrocnemius,  and  near  the  ankle,  joins  the  Ex- 
ternus  Saphenus  or  Communicans  Tibiae,  which  is  a branch 
of  the  Posterior  Tibial.  The  Peroneal  thence  is  directed 
towards  the  head  of  the  Fibula,  and  divides  into  two 
large  branches,  viz. : 

External  Peroneal — Descends  from  the  head  of  the  Fibula,  giving 
off  filaments  to  the  muscles  arising  therefrom.  At  the 
lower  part  of  the  leg  it  becomes  Superficial,  and  gives  off 
cutaneous  branches  about  the  External  Malleolus,  instep 
and  toes. 

Anterior  Tibial.  — Commences  at  the  bifurcation  of  the  Peroneal ; 
passing  under  the  heads  of  the  muscles,  reaches  the  Inter- 
osseous ligament,  upon  which  it  descends  in  company  with 
the  Anterior  Tibial  artery.  It  is  distributed  to  the  muscles 
and  integuments  upon  the  upper  surface  of  the  foot,  one 
branch  descending  to  the  sole  in  company  with  the  Pedal 
artery. 

Popliteal. — Descends  between  the  heads  of  the  Gastrocne- 
meus,  and  then  perforates  the  Soleus  muscle.  Below  the 
knee  it  receives  the  name  of  Posterior  Tibial. 

External  Saphenus.  — Is  given  off  from  the  Popliteal ; descending 
anteriorly  and  near  the  ankle,  is  joined  by  the  Internal 
Peroneo-Cutaneous.  The  common  trunk  thus  formed, 
passes  behind  the  External  Malleolus,  and  gives  off  cuta- 
neous branches  to  the  foot  and  toes. 

Posterior  Tibial.  — Descends  upon  the  back  of  the  leg  under  the 
Triceps  Surae  Muscle,  in  company  with  the  Posterior  Tibial 


30 


OUTLINES  OF  THE  NERVES. 


artery  : it  gives  off  numerous  muscular  branches,  and 
passing  under  the  sinuosity  of  the  os  calcis,  it  divides  into 
the  following : 

.t'-i  i...  - ..... 

External  Plantar.  — Accompanies  the  External  Plantar  artery 
along  the  outer  edge  p£rthe  sole  of  the  foot.  It  sends  off 
branches  to  the  muscles  of  the  sole,  to  the  little  toe,  and 
to  the  outer  side  of  the  next  toe. 

Internal  Plantar.  — Is  larger  than  the  external,  and  passing  along 
the  inner  edge  of  the  foot,  is  distributed  to  both  sides  of 
the  three  inner  toes  and  the  inside  of  the  fourth  toe. 


■-  on  -Uu  l>i-K  ,,v 

,*x\  i _ 


loxiuaiii  vi 


itvrxa”' 


FINIS. 


v )A  r i 


oricii.  lo  • .ri  J 


Just  Published  by 

BARRINGTON  di  HASWELL, 

OUTLINES  OF  THE  ARTERIES, 

Wimll  H3)IS®(SISEIFirE@lS'i  g 

DESIGNED  FOR  THE  USE  OF  MEDICAL  STUDENTS. 

By  JOHN  NEILL,  M.D., 

• . . & 3 * ...  ° ~ « *'  ^ \ 

Demonstrator  of  Anatomy  in  the  University  of  Pennsylvania;  Physician  to  Wills’s 
Hospital;  Lecturer  on  Anatomy  ; Member  of  the  Philadelphia 
Medical  Society,  etc.,  etc. 

Coloured  Engravings. 

%*  This  beautiful  little  work  is  a perfect  chart;  where  the  artery  and  its  name 
are  seen  side  by  side. 

“ This  book  should  he  in  the  hand  of  every  medical  student.  It  is  cheap,  portable, 
and  precisely  the  thing  needed  in  studying  an  important,  though  difficult  part  of 
Anatomy.” — Boston  Med.  and  Surg.  Journ. 

“ Its  chief  excellency,  however,  is  its  mode  of  reference,  in  which  it  differs  from 
the  usual  method  of  numbering  the  different  vessels,  and  referring  to  their  numbers 
in  the  accompanying  explanation.” — Med.  Exam. 

“ The  drawings  are  very  distinct  and  well  coloured.  The  idea  of  this  work  was 
a happy  one,  and,  we  trust,  for  the  benefit  of  students,  that  the  author  will  extend  it 
to  the  veins,  nerves,  &c.” — Amer.  Jour.  Med.  Sciences. 

“ As  a help  to  the  Medical  Student,  we  can  cheerfully  recommend  it.” — Western 
Lancet. 

Extract  from  a Letter  of  Prof.  Webster,  dated  Geneva,  Oct.  13  th,  1845. 

“ I have  examined  it,  and  think  it  a very  useful  work,  so  much  so  that  I shall  re- 
commend it  to  my  class,  and  adopt  the  arrangement  in  my  description  of  that  system.” 


A MANUAL  OF  EXAMINATIONS 

UPON  ANATOMY  AND  PHYSIOLOGY,  SURGERY,  PRACTICE  OF  MEDICINE, 
CHEMISTRY,  MATERIA  MEDICA,  OBSTETRICS,  ETC. 

Designed  for  the  Use  of  Students  of  Medicine  throughout  the  United  States. 

By  J.  L.  LUDLOW,  M.D. 

1 vol.  I2mo. 

“In  this  ‘ Manual  of  Examinations’  the  questions  are  clearly  put,  and,  with  few 
exceptions,  well  and  distinctly  answered.”  “The  Manual  will  be  found  to  be  equally 
available  at  the  three  schools  in  Philadelphia,  as  at  the  two  in  New  York,  or  those 
of  Louisville,  Lexington,  and  Cincinnati,  or  of  Charleston,  Augusta,  and  New 
Orleans,  not  to  mention  the  numerous  confreries  for  teaching  down  East.”  — Bull. 
Med.  Science. 

“We  have  no  hesitation  in  saying,  that  Dr.  Ludlow’s  Manual  is  decidedly  the 
best,  both  in  relation  to  comprehensiveness  and  general  accuracy,  that  has  yet  been 
published  in  this  country.” — Western  Lancet. 

“ Dr.  Ludlow  discovers  a minute  knowledge  with  all  the  leading  departments 
of  professional  lore,  which  he  imparts  agreeably.  He  is  careful  to  be  exact,  without 
being  redundant  in  any  paragraph.” — Boston  Med.  and  Surg.  Jour. 

“ Between  all  the  classes  whose  comfort  the  Student's  Manual  is  designed  to  pro- 
mote, we  should  think  it  would  obtain  not  a little  currency.” — West.  Journ. 


MINOR  SURGERY: 

eehm®©  ®sr  ifihbi  mwsnns  ©if  msm  ©wh-®ie®i$0 

Bv  HENRY  H.  SMITH,  M.D., 

Lecturer  on  Minor  Surgery,  Fellow  of  the  College  of  Physicians,  etc.,  etc- 
Illustrated  by  numerous  Engravings.  1 vol.  18mo.  muslin. 

“ And  a capital  little  book  it  is Minor  Surgery,  we  repeat,  is  really  Major  Sur- 

gery, and  any  thing  which  teaches  it  is  worth  having.  So  we  cordially  recommend 
this  little  book  of  Dr.  Smith’s.” — Med.  Cliir.  Rev. 

“ This  beautiful  little  work  has  been  compiled  with  a view  to  the  wants  of  the  pro- 
fession in  the  matter  of  Bandaging,  &c.,  and  well  and  ably  has  the  author  performed 
his  labours.” — Med.  Examiner. 

“ To  students  we  would  particularly  recommend  Dr.  Smith’s  work ; and  with  it  in 
their  possession,  they  would  be  able  to  carryout  togreat  advantage  the  advice  of 
an  eminent  professor  of  a neighbouring  city  — ‘ Provide  yourselves  each  with  half 
a dozen  rollers,  and  after  your  day’s  study  is  over,  just  before  going  to  bed,  amuse 
yourselves  by  bandaging  each  other.  It  is  the  only  way  to  acquire  an  art,  ignorantly 
underrated,  but  of  immense  importance.’  ” — Boston  Med.  and  Surg.  Journ. 

“This  is  an  excellent  Treatise  on  Bandaging, and  will  prove  of  great  assistance  to  the  student 
and  to  the  country  practitioner.”  “The  book  is  very  handsomely  illustrated  with  a great  number 
of  excellent  wood-cuts.  The  paper  and  type  are  good.  We  repeat,  in  conclusion,  our  very  favour- 
able estimation  of  its  merits.”— Med.  Exam. 

“ We  venture  to  predict  for  this  little  volume  a successful  career,  for  we  have  here  a means 
adapted  to  an  end."  “ Here  are  furnished  to  the  student  all  the  various  inventions  and  modifica- 
tions of  bandages  and  apparatus,  more  especially  by  the  American  Surgeons,  Physick,  Dorsey, 
Gibson,  Barton,  Coates,  Hartshorne,  and  N.  R.  Smith." — N.  Y.  Jour,  of  Med. 

“ We  have  no  hesitation  in  asserting,  that  it  is  an  excellent,  we  were  going  to  say  indispensable, 
aid  to  all  those  who  wish  to  qualify  themselves  Dr  the  practice  of  surgery.”— Bull,  of  Med.  Science. 


MIDWIFEE.Y  AND  EZSEASSg  OF  WO 2*2 SSI, 

Robert  Lee. 

LECTURES  ON  THE 

THEORY  AND  PRACTICE  OF  MIDWIFERY. 

DELIVERED  IN  THE  THEATRE  OF  ST.  GEORGl’s  HOSPITAL. 

Bi  ROBERT  LEE,  M.D.,  F.R.S., 

Fellow  of  the  Royal  College  of  Physicians,  Loudon;  Physician  to  the  British  Lyiug-iu 
Hospital ; and  Lecturer  on  Midwifery  at  St.  George’s  Hospital. 

Illustrated  with  numerous  Wood  Engravings.  1 vol.  8vo. 

“ Dr.  Lee’s  former  reputation  for  large  practical  knowledge  of  obstetrics  is  fully 
sustained  in  the  present  work.”  “ The  style  is  plain  arid  clear,  and  the  facts  and  cases 
are  presented  with  due  succinctness.  One  important  feature  is  the  introduction  of 
tables  of  the  results  of  certain  operations,  as  of  craniotomy,  and  of  certain  diseases  of 
the  puerperal  state,  as  puerperal  fever;  which  constitute  a statistical  basis  for  future 
observations  and  a present  support  for  active  and  available  practice.” — Bulletin  of 
Medical  Science. 

“ Dr.  Lee  is  too  good  and  sensible  an  author  to  be  reviewed.  He  should  be  read. 
He  has  already,  though  but  a young  man,  become  illustrious  by  his  earlier  works.” 
— Philad.  Med.  Exam. 

“ We  can  cheerfully  commend  it  to  the  notice  of  studeuts  of  medicine.” — Western 
Lancet. 

“ It  is  the  production  of  a highly  cultivated  and  practical  mind,  and  has  been  ela- 
borated with  adegree  of  judgment  and  care  which  must  render  the  Lectures  a valu- 
able record  of  professional  learning  and  experience.” — Western  Journal  of  Med. 
Sciences. 

“ While  they  are  well  adapted  for  the  instruction  of  the  student  of  midwifery,  the 
Lectures  of  Dr.  Lee  may  be  consulted  by  the  young  practitioner  with  much  satisfac- 
tion and  profit.  The  wood  engravings,  by  which  ihe  text  is  accompanied,  are  well 
executed,  and  communicate  a very  accurate  idea  of  the  subjects  they  are  intended  to 
illustrate.” — Anter.  Jour.  Med.  Science. 


J 

Neill 

181+5 


